The Journey to the End of Smoking: A Personal and Population Perspective

Background: Smoking cessation is best represented as a journey and not a single event. This article chronicles the path of change for the population of smokers in Maryland.

Purpose: This study compared the population of ever-smokers in Maryland over three time points (2000, 2002, and 2006) examining how the population of ever-smokers shifted over time.

Methods: Analysis of process of change and social influence variables conducted using data from the Maryland Adult Tobacco Surveys (MATS) administered in 2000, 2002, and 2006.

Results: Analyses indicated an increasing percentage of ever-smokers (100 lifetime cigarettes) who have successfully quit and maintained cessation for more than 5 years. By 2006, the population of current adult smokers (aged > or =18 years) was smaller but seemed less interested in and able to quit. More 2006 smokers were in earlier stages of change for cessation and not interested in or planning to quit in the near term. Many had unsuccessfully tried to quit, with a substantial minority finding that cessation products found effective in research were not effective for them. Despite past failures, the vast majority expects to quit, has considered quitting, and believes that they will likely succeed eventually. Larger percentages of 2006 smokers are being advised to quit by medical professionals, are accessing empirically supported quit-smoking aids, and have multiple quit attempts. They also smoked every day for more years, smoked as many cigarettes per day, and had environments as filled with smoking as their 2000 and 2002 counterparts.

Conclusions: Increasing successful cessation would require not only appropriate use of effective products but also successful negotiation of important tasks in the cessation journey. Health literacy and a consumer perspective can help to bridge gaps in the dissemination and effective use of empirically supported treatments.